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Eating Disorders Inpatient (Criteria for admission only need 1 of these…
Eating Disorders Inpatient
In inpatient setting, treating malnutrition!
Can't do therapy with starved brain
To reduce time in hospital
Criteria for admission
only need 1 of these
Electrolyte disturbance
Failure of outpatient tx
BP <90/60 or >10mmHg postural drop with standing
Suicidality
HR <40 or >100
Rapid wt loss
BMI <14 - psychiatric ward
Neutrophils <1.0
BMI<12 - medical ward
BGL <2.5mmol/L
Guidelines for MGT
4 primary goals of tx
Prevention and tx of refeeding syndrome
Wt restoration
Medical stabilisation
Reversal of cognitive effects of starvation
3 key components
Nursing Mgt
Nut. Mgt
DTN's role
Engage pt
Clinical role v therapeutic role
ADIME
Part of MDT
Onward referral
Medical Mgt
Nutritional Ax
Anthro
Biochem
Social hx
Determining support people is important to recovery
Clinical
Determine menstruation
If amenorhea for >6mths need bone density scan
Dietary
Eating and compensatory behaviours
Avoided food groups, vegetarian eating
Food segregation (good v bad foods)
Attitude to food and nut
Trigger foods
Rituals and obsessive eating behaviours
Exercise practices
Risk of fainting on run - perhaps encourage gym to solitary as help is there
Fluids, diet drinks, chewing gums
Duration, frequency, timing, location of meals
Purging, laxatives, diuretics (careful not to give ideas)
Re-feeding risk
Goals of treatment (pt and treating team goals)